Regional homogeneity alterations in patients with breast cancer: Mediation between anxiety sensitivity and health anxiety-related metacognition.

OBJECTIVES

To investigate the impact of anxiety sensitivity (AS) on regional spontaneous neural activity in patients with breast cancer and to explore the interplay among brain activity, AS, and health anxiety-related metacognition (MC).

METHODS

Sixty-four breast cancer patients (33 with high AS[HAS-BC], 31 with low AS[LAS-BC]) and 42 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging(rs-fMRI). Regional homogeneity (ReHo) was calculated and analyzed using one-way analysis of variance (ANOVA), followed by post hoc analysis (Gaussian random field correction, voxel-level p < 0.001, cluster-level p < 0.05). Correlations between ReHo values and clinical scores (Anxiety Sensitivity Index-3 [ASI-3], Metacognitions Questionnaire-Health Anxiety [MCQ-HA], and Generalized Anxiety Disorder 7-item scale [GAD-7]) were examined. A mediation model was constructed to investigate relationships among neural activity, AS and health anxiety-related MC.

RESULTS

Eight brain regions exhibited significant ReHo differences among the three groups: left pons, right inferior temporal gyrus (ITG), left middle temporal gyrus, right cerebellum lobule 4 and 5, right insula, right superior frontal gyrus, left postcentral gyrus, and right supplementary motor area. In breast cancer patients, ReHo in the right ITG was negatively correlated with MCQ-HA scores (r = -0.395, p = 0.0012). Mediation analyses revealed that ReHo in the right ITG mediated the relationship between ASI-3 and MCQ-HA scores (indirect effects = 0.111, 95 % CI [0.027, 0.238]).

CONCLUSIONS

Altered spontaneous brain activity characterizes breast cancer patients with different levels of AS. Specifically, decreased ReHo in the right ITG mediates the relationship between AS and health anxiety-related MC in breast cancer patients.